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Obesity/Overweight Among Healthy Adult Males Seeking Employment In Original Article Obesity/Overweight Pak Armed Forces Med J 2013; 63 (4): 534-38 OBESITY/OVERWEIGHT AMONG HEALTHY ADULT MALES SEEKING EMPLOYMENT IN PAKISTAN ARMY Muhammad Younas*, Afzal Ahmad Khan**, Muhammad Siddique*, Rashid Aleem Ahsan** *Combined Military Hospital, Risalpur,** Recruitment Office Risalpur Cantonment ABSTRACT Objective: To calculate the frequency of individuals having overweight / obesity as determined by body mass index. Study Design: Descriptive study. Place and Duration: Medical Inspection Room Engineer centre Risalpur and Department of Pathology Combined Military Hospital, Risalpur from 1st March 2010 to 30th September 2010. Material and Methods: Five hundred males between 17-23 years of age who were physically fit and had height within their 95th confidence interval, were enrolled in the study by non-probability convenience sampling. Results: Among 500 males, mean age was 20 ± 1.2 years, and age range was 17 to 23 years. Among them 418 cases belonged to rural areas and 82 candidates belonged to urban areas. Ninety seven (19%), belonged to group 1, 347 (69%) individuals belonged to group 2, 44 (8.8%) individuals belonged to group 3 and 12 (2.4%) individuals belonged to group 4. Blood pressure and pulse was recorded under standardized conditions. In group 2 (n= 347) only 8 individuals had BP > 120/80 and < 140/90 mmHg whereas in group 3 and 4 (n=56), 7 individuals had BP >120/80 and < 140/90 mmHg and 2 individuals had BP > 140/90 mmHg, however none of the individual had any irregularity of pulse among all groups. Among the 500 individuals, a questionnaire was distributed, 93% knew that overweight was related to diseases. About losing weight; 10% individuals replied dieting, 16% individuals replied exercise, 67% individuals replied both exercise and dieting, and 7% individuals did not know the way to lose weight. Conclusion: Frequency of overweight / obesity was 11.2% among healthy adult males. Comprehensive health care awareness campaigns involving food intake, regular aerobic exercise and maintaining weight is strongly recommended in younger population so as to promote public health. Keywords: BMI, Obesity Overweight. INTRODUCTION overweight and obesity has increased 4-6 Obesity is one of the most common dramatically in recent years . In Pakistan obesity disorders seen in medical practice which is very is one of the major nutritional problems. It peaks frustrating and difficult to manage and assessed increases with advancing age, at 45-64 years for by excess of adipose tissue. Accurate both men and women in urban and rural settings 7 quantification of body fat requires sophisticated and then decreases after 65 years . The National techniques not usually available in clinical Health Survey of Pakistan (NHS) 1990-1994 practice1. More quantitative evaluation to detect revealed that 1% of the population in Pakistan excess body fat is preformed by calculating the was reported to be obese and 5% overweight in 8 body mass index (BMI) by dividing measured the 15-24 years age group . Studies from Pakistan body weight in kilograms by the height in meter have given figures of 25% people having 9 squares i.e kg/(m2)2,3. overweight and obesity . In the developing world, prevalence of It is to be emphasized that in South Asia, including Pakistan, social and environmental Correspondence: Maj Muhammad Younas, CMH changes are occurring rapidly, with increasing Risalpur. urbanization, changing lifestyles, higher energy Email: [email protected] density of diets, and reduced physical activity10. Received: 12 Jan 2011; Accepted: 02 April 2013 Obese individuals differ not only in the amount 534 Obesity/Overweight Pak Armed Forces Med J 2013; 63 (4): 534-38 of excess fat, but also in the regional distribution Group 1- BMI<18 kg/(m)2 of fat within the body and both general and Group 2- BMI 18-22.9 kg/ (m)2 abdominal adiposity are associated with the risk Group 3- BMI 23- 24.9 kg/ (m)2 of death11. Similarly obesity has numerous social consequences in later life such as lower wages, Group 4- BMI ≥ 25 kg/ (m)2 less likelihood of marriage, and less education12. Simultaneously their blood pressure (BP) World Health Organization has and pulse was recorded after individuals had recommended different BMI cut-off points for rested for 5 minutes with back supported in South East Asia because they have more sitting position, by the same calibrated morbidity for any given BMI13. Indo-Asian sphygmomanometer. specific definition of obesity is set as BMI ≥ 25 Statistical analysis kg/ (m2) and overweight as BMI ≥ 23 kg/ (m2)14. Statistical analysis of data was done by using In Pakistan the obesity pattern is currently in statistical package for social sciences (SPSS) a transition from acute to an increase burden of version 11.0. Descriptive statistics were carried chronic disease15. So present study was out to summarize the data. Frequency and conducted to find out the frequency of percentages were calculated for obesity and BP. overweight and obesity in healthy adults by Mean and standard deviation (SD) was calculated measuring their BMI kg/ (m2) in our setup. for numerical data including age, height, weight MATERIAL AND METHODS and BMI. Data was compared by student 't' test among different groups. p value < 0.05 was A descriptive study was carried out at considered significant. Medical Inspection room Engineer Centre Risalpur and Department of Pathology RESULTS Combined Military Hospital, Risalpur from 1st Among 500 males mean age was 20 ± 1.2 March 2010 to 30th September 2010. Five years. Age range was 17 to 23 years. Among 500 hundred males were enrolled in the study by candidates, 418 cases belonged to rural areas and non-probability convenience sampling between 82 candidates belonged to urban areas (Fig-1). 17-23 years who were physically fit and had Province wise maximum candidates 437 (87%) height within their 95th confidence interval. A belonged to Punjab out of which 46 individuals questionnaire was given to each candidate asking (10.5%) had BMI ≥ 23 kg/ (m)2. Candidates from whether he knew that overweight is related to Sindh, Khyber Pakhtunkhwa, and Kashmir and diseases and how can weight be lost; whether by Northern Areas were 6, 45 and 12 respectively. dieting, exercise, by both or he didn’t know. Ninety seven (19%), 86 rural and 11 urban In order to compute BMI, the height and individuals belonged to group 1, 347 (69%) weight of each individual was measured after individuals belonged to group 2, whereas 44 completion of the questionnaire. For this purpose (8.8%) individuals belonged to Group 3 and 12 standardized weighing scales and measuring (2.4%) individuals belonged to Group 4 as shown tapes were used. The formulae utilized during in fig-2. Out of 56 individuals in group 3 and 4, 43 the data collection process are as follows: belonged to rural (10.2% of total rural cases) and BMI=weight(kg)/ height(m)2 13 belonged to urban areas (15.8% of total urban cases). The cutoff criteria used for the BMI: BMI<18 kg/(m)2-underweight, 18-22.9 kg/(m)2-normal In group 1 (n=97) all the individuals had BP weight, 23- 24.9 kg/(m)2- overweight and ≥ 25 < 120/80 mmHg, in group 2 (n=347) 8 kg/ (m)2-obese16,17. On the basis of BMI, individuals (2.3%) had BP > 120/80 < 140/90 individuals were divided into four groups as; mmHg, whereas in group 3 and 4 (n=56), 9 535 Obesity/Overweight Pak Armed Forces Med J 2013; 63 (4): 534-38 individuals (16%) had increased BP including 7 have suggested lower BMI cutoff values to define individuals with BP >120/80 < 140/90 mmHg overweight (23.0–24.9 kg/m2) and obesity (25.0 Table-1: Blood pressure record in various groups categories based on body mass index (BMI) (n=500). S/no Blood pressure Group 1 Group 2 Group 3 Group 4 mmHg (n=97) (n=347) (n=44) (n=12) 1 <120/80 97 339 40 7 2 >120/80 <140/90 0 8 4 3 3 ≥140/90 0 0 0 2 and 2 individuals with BP ≥ 140/90 mmHg (Table-1). No individual had any irregularity of 16.40% pulse in all four groups. rural Among 500 individuals to whom the population questionnaire was administered, no refusals were urban encountered, 93% knew that overweight was 83.60% related to different diseases. About losing weight; population 10% individuals replied dieting, 16% individuals replied exercise, 67% individuals replied both exercise and dieting, and 7% individuals did not know the way to lose weight. Figure-1: Rural and urban distribution of the DISCUSSION participants (n=500). Developing countries are increasingly vulnerable to the worldwide epidemic of obesity, 350 obese which affects all segments of the population18. In 300 return obesity/overweight, is a significant risk 250 over weight factor for arteriosclerosis, ischemic heart disease 200 150 normal and diabetes; all of which are major causes of weight 19,20 100 morbidity and mortality . underweigh 50 t Present study has shown that 8.8% 0 participants were overweight and 2.4% were obese which is in accordance with NHS 1990-94 and Al- Tawarah YM et al who has shown that Figure-2: Body mass index (BMI) distribution nearly 12% participants were overweight or obese of the participants (n=500). 21 in Jordan . Whereas Asif SA et al have reported kg/m2 or greater) in Asian populations24,25. We the higher prevalence of obesity in males in our have used a BMI cutoff values (23 kg/m2) to 22 set up as 7% and overweight as 34% . Similarly define overweight in accordance with the study the Metroville study in Karachi (2006) reported of Jafar et al who had concluded that for that 34% of men in the lower socio-economic identification of those at risk of hypertension and 23 group were obese/ overweight and Jafar et al diabetes and healthy targets may require the use has noted that 1 out of 4 Pakistani over the age of of even lower BMI cutoff values (<23 kg/m2), 17 15 years is overweight or obese .
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